Echocardiographic predictors of functional capacity in endomyocardial fibrosis patients.
OBJECTIVE
Endomyocardial fibrosis (EMF) is a restrictive cardiomyopathy manifested mainly by diastolic heart failure. It is recognized that diastole is an important determinant of exercise capacity. The purpose of this study was to determine whether resting echocardiographic parameters might predict oxygen consumption (VO(2p)) by ergoespirometry and the prognostic role of functional capacity in EMF patients.


RESULTS
A total of 32 patients with biventricular EMF (29 women, 55.3 +/- 11.4 years) were studied by echocardiography and ergoespirometry. The relationship between the echocardiographic indexes and the percentage of predicted VO(2p) (%VO(2p)) was investigated by the 'stepwise' linear regression analysis. The median VO(2p) was 11 +/- 3 mL/kg/min and the %VO(2p) was 53 +/- 9%. There was a correlation of %VO(2p) with an average of A' at four sites of the mitral annulus (A' peak, r = 0.471, P = 0.023), E'/A' of the inferior mitral annulus (r = -0.433, P = 0.044), and myocardial performance index (r = -0.352, P = 0.048). On multiple regression analysis, only A' peak was an independent predictor of %VO(2p) (%VO(2p)= 26.34 + 332.44 x A' peak). EMF patients with %VO(2p)< 53% had an increased mortality rate with a relative risk of 8.47.


CONCLUSIONS
In EMF patients, diastolic function plays an important role in determining the limitations to exercise and %VO(2p) has a prognostic value.
Salemi
Vera M C
VM
University of São Paulo Medical School, Brazil. verasalemi@uol.com.br
Leite
João J
JJ
Picard
Michael H
MH
Oliveira
Leila M
LM
Reis
Soraya F
SF
Pena
Jose L B
JL
Mady
Charles
C
D015150:Echocardiography, Doppler / Q000379:methods*; D004719:Endomyocardial Fibrosis / Q000000981:diagnostic imaging / Q000378:metabolism* / Q000401:mortality; D005260:Female; D006439:Hemodynamics; D006801:Humans; D008875:Middle Aged; D010101:Oxygen Consumption; D011446:Prospective Studies; D013147:Spirometry / Q000379:methods; D015996:Survival Rate / Q000639:trends